A randomized prospective comparative study of weight gain between asenapine and iloperidone in patients with psychosis

Background: Second-generation antipsychotics (SGAs) are better for psychotic disorders, and they can induce weight gain and other serious metabolic adverse effects which can lead to non-adherence and medical comorbidities. Iloperidone and asenapine, the newer SGAs with favorable short-term side effect profile. Aims and Objective: The aim of this study was to compare the weight gain propensity associated with new SGAs drugs-asenapine and iloperidone. Materials and Methods: Randomized prospective study was conducted from December 2014 to August 2015 in the Department of Psychiatry, Tertiary Care Hospital, Mysore. 60 patients who met the criteria for acute psychosis and schizophrenia according to ICD 10 were recruited. Atypical antipsychotics, asenapine (5-20 mg), and iloperidone (8-24 mg) were administered, and their weight was measured using the digital weighing scale on day 0 (baseline), week 1, week 3, and week 6. Results: Out of 60 recruited subjects, 51 (85%) completed all four visits of the study, 41.67% with asenapine, 43.3% with iloperidone. Mean weight gain was 2.18 ± 1.84 kg with iloperidone and 1.63 ± 1.28 kg with asenapine, but it was not statistically significant between the groups. Weight gain was dose dependent; 3.56 kg mean weight gain with 15-20 mg of asenapine and 3.36 kg with 18-24 mg iloperidone-treated patients which was statistically significant. Conclusion: Mild to moderate weight gain was seen in both asenapine and iloperidone and it was dose dependent. Iloperidone showed more weight gain than asenapine.